Asthma status and suicidal behavior risk: A meta-analysis of cohort studies

Objective: This meta-analysis investigates the differential risks of suicidal behaviors (ideation, attempts, mortality) associated with current asthma and asthma history. Method: Retrieve cohort studies on the association between asthma and suicide from PubMed, Embase, and Cochrane library database. Use the Newcastle Ottawa Quality Assessment Scale (NOS) to assess the risk of bias. The risk ratio (RR) of 95% confidence interval (CI) was summarized using a random effects model, and publication bias was evaluated using funnel plots and Egger’s trials. Result: A total of 12 cohort studies were included and published between 2005 and 2024. The NOS scores for the 12 cohort studies included in this meta-analysis ranged from 7 to 9. Most studies received scores of 7 or 8, indicating a generally high quality. Current asthma conferred a 62% increased risk of suicidal behaviors (RR = 1.62, 95% CI: 1.38–1.88), with suicide attempts showing the strongest association (RR = 2.27, 95% CI: 1.33–3.89). Asthma history was linked only to elevated suicide mortality (RR = 1.87, 95% CI: 1.64–2.14), not non-fatal suicidal behaviors. Conclusion: Current asthma status is associated with an increased risk of suicidal behaviors, but a history of asthma correlates only with elevated suicide mortality. This finding highlights the need for proactive mental health screening in asthma management protocols, especially during periods of active disease.